Medical Home-Head Start Partnership to Promote Early Learning for Low-Income Children

Health Promot Pract. 2019 May;20(3):429-435. doi: 10.1177/1524839918764894. Epub 2018 Apr 2.


Objective: To improve Early Head Start/Head Start (EHS/HS) screening, referral, and enrollment for children from diverse, low-income communities.

Method: Using existing resources, we built a pediatric clinic-Head Start partnership. Key steps included (1) screening protocol and tracking system, (2) a community partner as a single point of referral contact, (3) provider education, and (4) monthly outcome reporting. A pre- and post-cross-sectional study design was used to evaluate outcomes, with medical chart review conducted for all wellness visits among children aged 0 to 4 years pre- and postintervention.

Results: The preintervention group included 223 patients. The postintervention group included 235 patients. EHS/HS screening improved significantly after the intervention, rising from 8% in the preintervention period to 46% in the postintervention period (odds ratio [OR] 10.5, 95% confidence interval [CI] [5.9, 19.4]). EHS/HS documented referral rates increased from 1% in the preintervention period to 20% in the postintervention period (OR 18.3, 95% CI [5.7, 93.6]). Thirty-two of the 42 patients in the postintervention group referred to EHS/HS were reached to determine enrollment status. Six children (14%) had enrolled in EHS/HS.

Conclusion: With use of existing resources, a medical home-Head Start partnership can build an integrated system that significantly improves screening and referral rates to early learning programs.

Keywords: early education; medical home–community partnership; underserved.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development
  • Child, Preschool
  • Cooperative Behavior*
  • Cross-Sectional Studies
  • Early Intervention, Educational / methods*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Patient-Centered Care / methods*
  • Poverty / statistics & numerical data*
  • Referral and Consultation
  • Socioeconomic Factors